![]() ![]() The ocular surface evaporation rate in the FES group was also higher than that of the normal subjects ( P < 0.0001). Nearly all patients with FES showed eyelid hyperpigmentation. The ocular skin temperature and water evaporation rate were higher in the FES group ( P = 0.0003 and 0.026, respectively). Kinetic analysis of tear interference images revealed that lipid spread in a vertical or mixed pattern in 18 eyes (75%) with a delayed spread time ( P = 0.0007), indicating that most of the patients had lipid tear deficiency. Except for one patient, all others showed abnormal tear film, with an average tear break-up time of 2.9 ± 3.7 seconds. There was a high correlation between the eye with the worse symptoms and the eyes with the more severe floppy lids ( P < 0.01) and with ocular surface evaporation rate ( P = 0.02). Data showing evaporation rate and thermometry were compared with those of 10 normal subjects. Tear film dynamics were evaluated by kinetic tear interference images, infrared thermometry, water evaporation rate, tear break-up time, and fluorescein clearance test. Sixteen patients with FES were consecutively examined. The hypothesis for the current study was that one contributing factor is the abnormality in tear film dynamics. Floppy eyelid syndrome (FES) presents nonspecific ocular surface irritation.
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